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Supreme Court Takes Step Toward Hearing Abortion Case

The Supreme Court took a tentative step on Thursday toward hearing a case on the regulation of abortion-inducing drugs, asking the Oklahoma Supreme Court to clarify the meaning of a law that state judges had struck down as an unwarranted curb on medical practice and the right to abortion.

The 2011 law voided in Oklahoma said that the drugs, which are widely used in medicinal, nonsurgical abortions, could be administered only in the dosage and manner specified by the Food and Drug Administration when it first approved their use in 2000. The law was promoted by anti-abortion groups in the name of protecting women’s health from “off-label” uses of the drugs that have become standard practice.

The procedure has come into wide use, accounting for nearly one-fifth of the country’s 1.2 million abortions in 2008, according to the Guttmacher Institute, a research group that supports abortion rights. Similar laws prohibiting departures from the 2000 labeling have been adopted in Ohio and Arizona, and restricting medicinal abortions has become a goal of anti-abortion forces.

Abortion doctors and major medical associations, who have refined the dosages and other aspects of medicinal abortions over the years, call these laws a transparent attempt to curb a procedure that in the early weeks of pregnancy is often preferable to a surgical abortion. More broadly, off-label uses of drugs are common and essential to medical practice, they argue.

“The F.D.A. doesn’t decide how doctors should prescribe drugs,” Julie Rikelman, litigation director for the Center for Reproductive Rights, a nonprofit legal advocacy organization, said in an interview on Thursday. “Doctors decide how to prescribe drugs.”

Her group, based in New York, has argued against the Oklahoma law in court on behalf of a coalition of women’s health advocates in the state.

An Oklahoma court ruled that the law violated women’s bodily integrity and right to abortion and struck it down, saying it “can serve no purpose other than to prevent women from obtaining abortions.” The state’s highest court affirmed that decision, and now the state attorney general has appealed to the Supreme Court, arguing that the law is a reasonable exercise of state power.

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One of the main drugs used in medicinal abortions, mifepristone, formerly known as RU-486, has been a subject of political strife for decades. In the 1990s, abortion opponents, fearing that it would make abortion too easy and acceptable, fought to prevent American approval of the drug, which had been widely used abroad.

In 2000, the F.D.A. approved the combination of mifepristone, a steroid that breaks down the lining of the uterus, and misoprostol, a prostaglandin that induces contractions. The agency did so based on clinical trials involving a large dose of mifepristone in the clinic, a dose of misoprostol in the clinic two days later, then a third clinic visit on the 14th day to verify that the embryo had aborted. The procedure was recommended for use through seven weeks of pregnancy.

Since then, studies have shown that mifepristone works as well at one-third the previously used dose, that it is safe to take the second medication at home, and that the procedure is safe and effective through the ninth week of pregnancy, according to the National Abortion Federation, the World Health Organization and other medical groups.

Serious complications are rare, most medical experts say. But anti-abortion groups argue that the off-label uses are unapproved and more dangerous.

Those who challenged the Oklahoma law say it has vague provisions that go beyond those in other states, barring all medicinal abortions and outlawing use of a drug to end ectopic pregnancies. The Supreme Court has asked the Oklahoma justices to clarify whether the law would have such sweeping effects.

But even if the law simply mandated the treatment regime approved by the F.D.A. in 2000, Ms. Rikelman said, it would still be medically unjustified and inhibit women’s exercise of their constitutional rights.

Correction: July 3, 2013

An article on Friday about a Supreme Court case involving medicinal, nonsurgical abortions in Oklahoma referred incorrectly to the stage of human development present when mifepristone, a steroid that breaks down the lining of the uterus, and misoprostol, a prostaglandin that induces contractions, were administered during a clinical trial. The developing egg is called an embryo, not a fetus.

A version of this article appears in print on June 28, 2013, on Page A12 of the New York edition with the headline: Supreme Court Takes Step Toward Hearing Abortion Case. Order Reprints|Today's Paper|Subscribe